Kumar Varma Kalidindi Kalyan, Sharma Jeevan Kumar, Vishwakarma Gayatri, Duggi Srinath, Chhabra Harvinder Singh
Department of Spine Service, Indian Spinal Injuries Center, Vasant Kunj, New Delhi, Delhi 110070, India
Department of Spine Service, Indian Spinal Injuries Center, Vasant Kunj, New Delhi, Delhi 110070, India.
Int J Spine Surg. 2022 Apr;16(2):300-308. doi: 10.14444/8221.
The literature has not distinguished between LF "hypertrophy" and "buckling" when addressing cervical spondylotic myelopathy. The identification of buckling on dynamic magnetic resonance imaging can determine the levels for decompression more accurately and modify the surgical plan accordingly. No studies have been performed in the cervical spine to analyze the factors affecting LF buckling.
Our objective was to investigate the factors affecting static ligamentum flavum (LF) "hypertrophy" and dynamic LF "buckling."
Retrospective cohort study.
We conducted a retrospective study of hospital records and imaging database from January 2014 to January 2020. The relation of age, disc height, and intervertebral instability to LF hypertrophy and buckling were assessed.
Measurements were performed from C2-3 to C7-T1 in 169 patients who satisfied the eligibility criteria, making a total of 1014 levels. The samples were divided into 2 groups: 798 levels with buckling <1 mm (group A) and 216 levels with buckling >1 mm (group B). Of those, 161 levels satisfied the criteria for radiological instability (sagittal translation/rotation). No correlation was observed between age/disc height and buckling. Intervertebral instability showed significant association ( = 0.046) with buckling. No correlation was found between age/intervertebral instability and hypertrophy.
LF buckling but not hypertrophy is related to intervertebral instability in the cervical spine. LF buckling in the cervical spine is not related to age or disc height in the cervical spine.
Intervertebral instability on dynamic x-ray imaging of the cervical spine can be a predictor of ligamentum flavum buckling and can be utilized for surgical planning.
在探讨脊髓型颈椎病时，文献中并未区分黄韧带“肥厚”与“褶皱”。动态磁共振成像上识别黄韧带褶皱可更准确地确定减压节段，并据此调整手术方案。目前尚无针对颈椎分析影响黄韧带褶皱因素的研究。
我们的目的是研究影响静态黄韧带“肥厚”和动态黄韧带“褶皱”的因素。
回顾性队列研究。
我们对2014年1月至2020年1月的医院记录和影像数据库进行了回顾性研究。评估年龄、椎间盘高度和椎间不稳与黄韧带肥厚及褶皱的关系。
对169例符合纳入标准的患者从C2-3至C7-T1进行测量，共1014个节段。样本分为两组：798个节段黄韧带褶皱<1mm（A组）和216个节段黄韧带褶皱>1mm（B组）。其中，161个节段符合影像学不稳标准（矢状面平移/旋转）。未观察到年龄/椎间盘高度与黄韧带褶皱之间存在相关性。椎间不稳与黄韧带褶皱显示出显著相关性（P = 0.046）。未发现年龄/椎间不稳与黄韧带肥厚之间存在相关性。
颈椎黄韧带褶皱而非肥厚与椎间不稳相关。颈椎黄韧带褶皱与颈椎的年龄或椎间盘高度无关。
颈椎动态X线成像上的椎间不稳可作为黄韧带褶皱的预测指标，并可用于手术规划。
